all thumbs

I didn’t stop running all day today. Surgery with the attending actually wasn’t too bad. He threw me a couple questions I knew the answers to, and then mainly stuck to the technical matters at hand.

The more time I spend around the OR, the more I realize how perfectly hopeless I am with any kind of tools. It’s kind of pathetic, really. I still, after nearly three years, struggle to move the armboards on the OR table, let alone attach leg-pieces or stirrups. The OR staff is still trying to explain to me how to tighten and loosen screw mechanisms. Every time I disassemble the piece we’re trying to put on, or lock down the piece we’re trying to take off, I want to say that this is why I’m not doing orthopedic surgery; but that would sound like I shouldn’t be doing general surgery either, so I keep quiet.

And those are the big mechanical objects – let alone the little things like scalpels, delicate scissors, probes, needles, etc. This is the first time I’ve tried to use most of these things, but somehow I was hoping the general concepts would come a little more naturally. Part of it is back to the problem I had with burn surgery: you have to seriously intend to do damage in order to get anywhere. You have to want to cut something so that it comes apart and bleeds. Wanting everything neat and natural is not going to get you anywhere. I’ve had so little experience that I’m not good at actually cutting someone.

I had the service basically to myself today. Some seniors were around, but extremely busy in the OR. Various patients had problems, and it would have been to inconvenient for all concerned to get ahold of them while scrubbed in. So I got through it by imagining myself reporting to them, and trying to think of all the indignant questions they would ask (urine electrolytes? oxygen saturation? surgeons like boluses! home medications? pre-op lab values?) and acting on them. To my surprise, almost everyone was doing better by the end of the day. An attending rounded, but he didn’t really want to hear what the precise urine output had been, or exactly how high the blood pressure had been, and so on. He did get interested in the patient who was hypotensive and anuric, but that was about it.

Later on in the day, there was somehow a big enough hole in the schedule that I spent nearly an hour assisting on a big case. The most I’ve done all year, and it was great to finally be close enough to see what was happening. Further reinforcement that I’m no good with tools; but they always say they could teach a monkey to do surgery, and I hope I can equal a monkey.